Glaucoma treatment aims to reduce intraocular pressure by improving aqueous outflow, or reducing the production of aqueous, or both to prevent damage to vision. Treatment options for glaucoma include eye drops, oral medications and surgery. Your d
Glaucoma treatment aims to reduce intraocular pressure by improving aqueous outflow or reducing the production of aqueous, or both to prevent damage to vision. Treatment may not cure glaucoma totally and damage to vision caused by the disease can't be reversed. If you have some vision loss, treatment can slow or prevent further vision loss. Early diagnosis and treatment can prevent visual loss in people with very early stage of glaucoma.
Treatment options for glaucoma include:
- Eye drops.
- Oral medications.
Most people are prescribed medicated eye drops initially. Use the drops exactly as recommended by your eye doctor. Otherwise, your vision loss (optic nerve damage) may progress. As some of the eye drops are absorbed into bloodstream, you may experience systemic side effects unrelated to your eyes. To minimise absorption of eye drops to blood stream, close your eyes for one to two minutes after putting the drops, press gently at inner corner of your eye (this closes the tear duct) for one or two minutes, and wipe off any excess drops from your eyelid.
Some of the commonly prescribed eye drops include:
- Prostaglandin-like compounds such as latanoprost and bimatoprost---these eye drops improve the outflow of aqueous humour (fluid formed in eyes).
- Beta blockers such as timolol, betaxolol, and metipranolol---these eye drops decrease the production of aqueous humour.
- Alpha-agonists such as apraclonidine and brimonidine ----these drops also decrease the production of aqueous humour.
- Carbonic anhydrase inhibitors such as dorzolamide and brinzolamide ---these drops also decrease the production of aqueous humour.
- Miotic or cholinergic agents such as pilocarpine and carbachol increase the outflow of aqueous humour.
- Epinephrine compounds such as dipivefrin improve the outflow of aqueous humour.
If eye drops alone are not able to control the pressure in your eyes to the desired level, the doctor may prescribe an oral medication. The oral medication is a carbonic anhydrase inhibitor which reduces the amount of aqueous humour produced in your eye. This helps to reduce intraocular pressure.
If the pressure in the eye is not reduced with medications (eye drops and oral medications) or if you can't tolerate medications, surgical procedure is recommended. In some patients a single surgical procedure may not reduce eye pressure to the desired level, and in this case you'll need to continue using eye drops or undergo another operation.
Some surgeries to treat glaucoma include:
- Laser eye surgery (a procedure called trabeculoplasty) is performed to open clogged drainage canals and allow aqueous humour to drain out easier from the eye.
- Filtering surgery (called trabeculectomy) is performed if eye drops and laser surgery are not effective in controlling your eye pressure.
- Drainage implants.
Treating acute angle-closure glaucoma
This type of glaucoma is a medical emergency. In this condition the doctor may administer several medications to reduce eye pressure rapidly and then may operate so that aqueous humour can drain.
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